TY - JOUR
T1 - Meta-analysis to assess the efficacy and toxicity of docetaxel-based doublet compared with docetaxel alone for patients with advanced NSCLC who failed first-line treatment
AU - Jin, Ying
AU - Sun, Yan
AU - Shi, Xun
AU - Zhao, Jun
AU - Shi, Lei
AU - Hong, Wei
AU - Yu, Xinmin
N1 - Funding Information:
This work was supported by the Wu Jie Ping Medical Foundation (grant no. 320.6750.13393). Dr. Jin designed the study and prepared the manuscript; Drs. Sun and X. Shi independently searched the databases; Drs. Zhao and L. Shi independently identified eligible trials; Dr. Hong took responsibility for the statistical analysis; and Dr. Yu edited and reviewed the manuscript. Dr. Yu is also the guarantor of this work and had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Publisher Copyright:
© 2014 Elsevier HS Journals, Inc. All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Purpose: The benefit of docetaxel-based therapy in the second-line treatment of advanced non-small cell lung cancer (NSCLC) is still unclear. The goal of this meta-analysis was to assess the efficacy and toxicity of docetaxel-based doublet compared with docetaxel alone for patients with advanced NSCLC who failed to improve with first-line treatment. Methods: Several databases were searched, including PubMed, Embase, and the Cochrane databases. The end points were overall survival, progression-free survival (PFS), objective response rate, disease control rate, and grade 3 or 4 adverse events. Data were extracted from the studies by 2 independent reviewers. The meta-analysis was performed by using Review Manager version 5.2. The pooled hazard ratio (HR) or odds ratio (OR) and 95% CIs were calculated by using fixed or random effects models depending on the heterogeneity of the included trials. Findings: Twelve eligible trials involving 2680 patients were identified. The intention-to-treatment analysis found that docetaxel-based therapy significantly improved overall survival (HR, 0.89 [95% CI, 0.83-0.96]; P < 0.01), PFS (HR, 0.79 [95% CI, 0.71-0.89]; P < 0.01), objective response rate (OR, 1.73 [95% CI, 1.37-2.18; P < 0.01), and disease control rate (OR, 1.30 [95% CI, 1.09-1.55]; P < 0.01). In addition, a subgroup analysis based on type of combined drug showed that there were significant improvement in PFS and overall survival in combining docetaxel with targeted therapy. In addition, a higher incidence of grade 3 or 4 diarrhea and thrombocytopenia was observed in docetaxel-based doublet therapy. Implications: Based on the available evidence, docetaxel-based doublet therapy seems superior to docetaxel monotherapy as a second-line treatment for advanced NSCLC. More studies should focus on combining docetaxel with targeted therapy to identify patients who will most likely benefit from the appropriate combination targeted therapy.
AB - Purpose: The benefit of docetaxel-based therapy in the second-line treatment of advanced non-small cell lung cancer (NSCLC) is still unclear. The goal of this meta-analysis was to assess the efficacy and toxicity of docetaxel-based doublet compared with docetaxel alone for patients with advanced NSCLC who failed to improve with first-line treatment. Methods: Several databases were searched, including PubMed, Embase, and the Cochrane databases. The end points were overall survival, progression-free survival (PFS), objective response rate, disease control rate, and grade 3 or 4 adverse events. Data were extracted from the studies by 2 independent reviewers. The meta-analysis was performed by using Review Manager version 5.2. The pooled hazard ratio (HR) or odds ratio (OR) and 95% CIs were calculated by using fixed or random effects models depending on the heterogeneity of the included trials. Findings: Twelve eligible trials involving 2680 patients were identified. The intention-to-treatment analysis found that docetaxel-based therapy significantly improved overall survival (HR, 0.89 [95% CI, 0.83-0.96]; P < 0.01), PFS (HR, 0.79 [95% CI, 0.71-0.89]; P < 0.01), objective response rate (OR, 1.73 [95% CI, 1.37-2.18; P < 0.01), and disease control rate (OR, 1.30 [95% CI, 1.09-1.55]; P < 0.01). In addition, a subgroup analysis based on type of combined drug showed that there were significant improvement in PFS and overall survival in combining docetaxel with targeted therapy. In addition, a higher incidence of grade 3 or 4 diarrhea and thrombocytopenia was observed in docetaxel-based doublet therapy. Implications: Based on the available evidence, docetaxel-based doublet therapy seems superior to docetaxel monotherapy as a second-line treatment for advanced NSCLC. More studies should focus on combining docetaxel with targeted therapy to identify patients who will most likely benefit from the appropriate combination targeted therapy.
KW - docetaxel monotherapy
KW - docetaxel-based doublet
KW - non-small cell lung cancer
KW - second-line therapy
UR - http://www.scopus.com/inward/record.url?scp=84917710708&partnerID=8YFLogxK
U2 - 10.1016/j.clinthera.2014.08.015
DO - 10.1016/j.clinthera.2014.08.015
M3 - Article
C2 - 25256387
AN - SCOPUS:84917710708
VL - 36
SP - 1980
EP - 1990
JO - Clinical Therapeutics
JF - Clinical Therapeutics
SN - 0149-2918
IS - 12
ER -